Supervisor - Care Management (Non-clinical)

What You’ll Do

• Provide day-to-day supervision of care management teams, ensuring adherence to ambulatory care management policies, procedures, and regulatory requirements.
• Supervises the delivery of clinical care management services across the continuum, supporting staff performance and clinical excellence.
• Ensure consistent application of policies and take corrective or disciplinary actions when necessary.
• Other projects and duties as assigned by Clinical Leadership team.

• Monitor and support implementation of the Astrana Health care management process -- including training and documentation requirements.
• Review health plan reports to identify new members requiring coordination of care or targeted interventions.
• Ensure all care management activities are compliant with NCQA standards, CMS, health plan and state regulations, and internal protocols.

• Support the development and review of individualized care plans and ensure integration of care strategies across disciplines.
• Engage with network PCPs, specialists, and vendors to ensure timely, appropriate care coordination and service utilization.
• Collaborate with internal departments including Utilization Management, Inpatient Case Management, and Ambulatory Care to ensure continuity across transitions of care.

• Conducts internal audits of ambulatory care management cases, provides feedback and coaching to staff as needed.
• Provide education and support to staff on documentation standards, best practices, and quality improvement opportunities.
• Assists with submission of deliverables for health plan audits.

• Conduct performance evaluations of care management staff, including audits of care plans, assessments, and documentation.
• Monitor staff attendance and ensure accountability to organizational expectations.
• Provide mentorship and training to foster a culture of excellence, collaboration, and continuous improvement.
• Oversee the hiring, onboarding, and training of new staff.
• Maintain the timekeeping and personnel records of staff.
• Other duties as assigned.

Qualifications

• High school diploma; diploma/certificate in management preferred.
• At least 2 years of case/care management experience in a medical group, IPA and/or HMO setting preferred.

• Knowledge of NCQA standards, Model of Care and Case Management requirements, CMS and state regulations, and HMO/ACO model structures.
• Strong communication, leadership, and critical thinking skills.
• Proven ability to work cross-functionally with clinicians, leadership, and administrative staff to drive outcomes.
• Experience in managing diverse teams and leading quality-focused initiatives.
• Skilled with the use of the Microsoft Office suite of products and the ability to use and effectively learn and navigate other computer systems.

Environmental Job Requirements and Working Conditions

• This is a remote position.
• Travel may be required based on business needs.
• The total compensation target pay range for this role is: $75,000 - $85,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.